Increasing the Number of Nurse Faculty with Doctoral Degrees: Outcomes of the Maryland Nurse Educator Doctoral Grant Program 2013-2018 SUSAN BATTISTONI, PhD, RN, is Professor Emerita, Sa
Trang 1NEARLY 1 MILLIONregistered
nurses in the United States will reach retire-ment age within the next 10-15 years (Keele & Alpert, 2015)
Moreover, one-third of current fac-ulty will retire by 2025, 44% of whom hold research-focused doc-torates (Fang & Kesten, 2017)
Though the Institute of Medicine
(IOM, 2010) report on The Future
of Nursing recommended 80% of
the nursing workforce be educated
at the baccalaureate level, nursing programs will be hampered in their ability to meet this goal because of the looming faculty shortage Thus, the nursing faculty shortage wors-ens the nursing shortage As noted
by Fang and Kesten (2017), there is
a “sense of urgency for the nursing education community to address the impending exodus of senior
faculty and to develop younger fac-ulty for their successful succes-sion” (p 633)
Since 2001, the mean age of full-time faculty at nursing schools offering baccalaureate and graduate education has increased steadily (American Association of Colleges
of Nursing [AACN], 2016) For doc-torally prepared faculty holding the ranks of professor, associate profes-sor, and assistant profesprofes-sor, mean age increased 6 years, 3.8 years, and 0.7 years, respectively This is sig-nificant because most vacant posi-tions within schools of nursing require or prefer faculty with a doc-toral degree (AACN, 2016) and the limited pool of doctorally prepared faculty was identified by 68.2% of programs as an issue in faculty recruitment (Oermann, Lynn, & Agger, 2016)
Increasing the Number of Nurse
Faculty with Doctoral Degrees:
Outcomes of the Maryland Nurse
Educator Doctoral Grant Program
2013-2018
SUSAN BATTISTONI, PhD, RN, is Professor Emerita, Salisbury University, Department of
Nursing, Salisbury, MD.
ANNE E BELCHER, PhD, RN, ANEF, FAAN, is Associate Professor (retired), Johns Hopkins
University School of Nursing; Associate Professor (clinical), Johns Hopkins University School of Education; Associate Professor (joint appointment), Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD.
PEGGY DAW, DNP, RN-BC, CNE, is Nurse
Support Program II Grant Administrator,
Maryland Higher Education Commission,
Baltimore, MD.
LISA A SELDOMRIDGE, PhD, RN, is
Professor of Nursing, Salisbury University,
Salisbury, MD.
E XECUTIVE S UMMARY
The nursing faculty shortage
worsens the nursing shortage.
The Nurse Educator Doctoral
Grants for Practice and
Dissertation Research (NEDG)
program was launched in 2012
to expedite doctoral degree
completion and reduce personal
debt for full-time nurse faculty in
Maryland.
The program provided financial
incentives to retain and develop
a cadre of nursing faculty with
terminal degrees.
The NEDG program met its
goals of increasing the number
of doctorally prepared faculty in
Maryland and retaining them in
teaching positions.
It is highly regarded by
awardees and clearly influential
in facilitating degree completion.
Peggy Daw Lisa A Seldomridge Susan Battistoni Anne E Belcher
Trang 2Maryland’s Nurse Faculty
Shortage
In 2003, the State of Maryland
identified a worsening nursing
shortage, with a 14.7% vacancy
rate in healthcare organizations,
along with a 6% decline in
enroll-ments and 9% drop in graduations
from Maryland nursing programs
Despite a variety of statewide
ini-tiatives, according to the 2014 U.S
Department of Health and Human
Services Health Resources and
Services Administration (2014),
Maryland is one of 16 states
pro-jected to have a significant shortfall
of RNs by 2025
The Nurse Educator Doctoral
Grants for Practice and Dissertation
Research (NEDG) program was
launched in 2012 to expedite
doc-toral degree completion and reduce
personal debt for full-time nurse
fac-ulty in Maryland Earlier research
(D Seigart, personal
communica-tion, 2011) found “time and money”
were the two greatest barriers to
doctoral degree completion for
employed nurse faculty Since 2013,
98 faculty from 22 Maryland
nurs-ing programs have received NEDG
awards Outcome data including
awardee sociodemographic profiles,
degree completion by type,
reten-tion in faculty role, and use of
NEDG funds are presented for
2013-2018 Recommendations for
pro-gram improvement and
implica-tions for nurse educators and
pro-gram administrators are discussed
Financial Support and the Impact
on Furthering Education
Peer review research findings
corroborate the influence of prior
college debt on the decision to
return to school Jones-Schenk,
Leafman, Wallace, and Allen (2017)
found that the academic
progres-sion plans of entry-level nursing
graduates were strongly influenced
by their existing financial
obliga-tions A study of deans and
direc-tors of nursing programs in eight
states revealed a lack of knowledge
regarding the financial incentives
for tuition support and loan
repay-ment (Morgan et al., 2014) While some states offered support for service (SFS) programs to “increase the pool of potential nurse faculty and to increase the educational qualifications of current nurse fac-ulty within the state” (Morgan et al.,
2014, p 282), nursing school administrators were not always aware of them Furthermore, there was mixed support for pursuit of a non-nursing doctoral degree even though varied educational back-grounds could enrich the fabric of the faculty providing nursing edu-cation (Morgan et al., 2014)
In a similar survey of Maryland Deans and Directors (Maryland Higher Education Commission, 2017a, 2017b), 18 of 28 academic leaders (64% response rate)
report-ed on their use of the state’s SFS programs Half of the respondents were from community colleges and half were from baccalaureate pro-grams The findings of the 20-ques-tion survey indicated 94% were aware of the SFS programs;
howev-er, only 56% used all three avail-able programs and 6% used none of them Of interest, 44% of the responding deans and directors had personally used at least one of the SFS programs The vast majority (89%) credited the SFS programs with increasing educational qualifi-cations of applicants and current faculty, recruiting faculty (89%), and retaining faculty (78%) These academic leaders supported fund-ing for a variety of doctoral degrees including the doctor of philosophy (PhD), doctor of education (EdD), and doctor of nursing practice (DNP)
Wheeler and Eichelberger (2017) explored factors influencing the pursuit of a doctoral degree and found that availability of scholar-ships, tuition reimbursement, time
of classes, available online courses, tuition costs, and work demands were important considerations
However, the most important moti-vating factor was personal develop-ment (62%) followed by career advancement (27%) More than half
of graduates (59%) planned a career
in academia, with 65% enrolled in research-focused programs and 48% enrolled in practice-focused programs (Wheeler & Eichelberger, 2017)
Whether funds for doctoral study are from federal, state, or pri-vate sources, nurses considering a program of study want assurance that financial support is available and will remain a source of contin-uous support (Nehls & Rice, 2014) Even when resources are offered for educational advancement, nursing faculty may not take advantage of them unless the academic culture serves as a motivator and encour-ages completion of doctoral degrees among faculty (Agger, Oermann, & Lynn, 2014)
In fiscal year 2015, the U.S Department of Education collected approximately $4.5 billion on defaulted student loans Around 114,000 borrowers, or a little less than 10% of those with student loans, had their Social Security payments garnished in that year The population of student debt holders aged 50-64 in default has increased 407% since 2002 The borrowers aged 65 and older facing Social Security garnishment have increased by 540% (Government Accountability Office, 2016) The number of students graduating in debt is mounting at an alarming rate Feeg and Mancino (2014) found that nursing students are similar to all other undergraduates with an average of $30,000 in stu-dent loans This has implications for pursuit and completion of advanced degrees and choosing an academic career that requires a doctoral degree
Doctoral Degree Choices and Impact on the Nurse Faculty Shortage
Although DNP education
focus-es on preparation of nursfocus-es for the advanced practice role, those gradu-ates are often sought as nurse educa-tors They are considered to be ideal for clinical teaching and advance-ment of translation of nursing knowledge into practice (Fang &
Trang 3Bednash, 2017) The percentage of
full-time nurse faculty with a DNP
in 2015 was 14% In their study,
Fang and Bednash (2017) found
56.8% of DNP students who
antici-pated a career in academia were
already full-time or part-time
facul-ty members
An issue not adequately ad
-dressed in the literature is the
preparation of both DNP and PhD
graduates for the faculty role The
National League for Nursing (NLN,
2017) recently issued Outcomes
and Competencies for Graduate
Academic Nurse Educator Prepara
-tion to guide schools of nursing, not
only those who offer graduate
degrees in nursing education but
also those whose DNP and PhD
stu-dents intend to pursue an academic
career
NEDG Program
The NEDG program was built
on analysis of existing
faculty-focused resources and direct
com-munication from Maryland deans
and directors of nursing programs
in 2011 who indicated the need for
current faculty to have the time and
funding to complete doctoral
degrees NEDG was structured to
provide a sustainable financial
solu-tion for faculty who recently
com-pleted doctoral degrees or who were
anticipating doctoral degree
com-pletion within the next 2 years The
maximum grant award was $30,000
per nominee which was distributed
to the employing institution for
release to faculty members for spe-cific degree-related expenditures
The only requirements of faculty awardees were continued progress toward degree completion/degree conferral, ongoing employment as a faculty member in good standing, submission of a copy of final schol-arly work, and citations of pub-lished work to be posted on the NSP
II website (www.nursesupport.org)
Nomination and eligibility.
Deans and directors of all Maryland nursing degree programs were
invit-ed to nominate an unlimitinvit-ed num-ber of current full-time faculty who met the criteria for degree comple-tion To be eligible, nominees were required to be in pursuit of an appropriate graduate degree and working in a full-time clinical, nurse educator, or nursing faculty position, as certified by the dean or director A nomination form, plan of study, support letter from the dean/director, and budget proposal describing both existing support and budgetary needs were required
Allowable expenditures included expenses related to dissertation research or capstone completion, tuition or loan repayment, profes-sional development, conference fees, travel expenses for speaking engagements, and professional asso-ciation membership dues A selec-tion panel reviewed all nominaselec-tions and made recommendations for funding
Program evaluation Program
evaluation used a retrospective,
longitudinal, post-hoc review of secondary data as well as informa-tion from a researcher-made, 20-item web-based survey which was sent to all NEDG grant recipients
(n=98) Sociodemographic data
included gender, ethnicity, birth generation, length of career nurs-ing experience, employment sta-tus, employer type and region, years expected to work as faculty, current salary range, and type of doctoral degree
sought/complet-ed Additional questions explored the impact of the NEDG grant on awardees personally, areas for which they used the funding, amount of student debt when NEDG was received, and strategies for recruitment and retention of nurse faculty Data were collected over a 2-month period from February 10 through April 15,
2017 with a 65% survey response (64/98)
Awards and faculty retention.
To date, 12 universities and 10 com-munity colleges from all regions of Maryland have accessed NEDG funds to support current faculty in doctoral degree completion This represents 76% of nursing programs
in the state From 2013-2018, 98 nurse faculty were awarded over
$2.35 million The distribution by year, total funding, and faculty reten-tion appear in Table 1 Over the 6 years of the NEDG program, the average retention of faculty was 88.8% Of the 11 faculty who left employment with Maryland nursing
Table 1.
Nurse Educator Doctoral Grants Distribution and Retention FY 2012-FY 2018
Fiscal Year NEDG Recipients Funding # Lost in Cohort Retention Rate
SOURCE: Maryland Higher Education Commission, Nurse Educator Doctoral Grants for Practice and Dissertation Research
(NEDG), 6-year program review completed December 8, 2017.
Trang 4programs, three returned to clinical
practice as advanced practice
nurs-es, seven moved out of state
relocat-ing to New York, South Carolina,
Pennsylvania, Massachusetts, West
Virginia (however, three became
directors of nursing programs), and
one retired
Profiles of recipients and de
-grees sought The majority of survey
respondents were female (92.2%,
n=59) and Caucasian (59.4%, n=38);
however, some diversity was noted
with 28% (n=18) self-identifying as
Black, 7.8% (n=5) Asian, 4.7%
(n=3) Hispanic/Latino, 1.56% (n=1)
American Indian, and 1.56% (n=1)
other The preponderance, 62.5%
(n=40), were from Generation X
(born between 1961 and 1981), with
29.69% (n=19) noted as Baby
Boomers (1943-1960), and 9.38%
(n=6) Millennials (1982-2000) This
group represented skillful nurses
with 56.5% (n=36) reporting 21
years to more than 40 years of
expe-rience, 23.44% (n=15) with 16-20
years, 12.5% (n=8) with 11-15 years,
6.25% (n=4) with 6-10 years, and
only one with less than 5 years
Degrees sought by year of
NEDG award appear in Table 2
Consistent with national trends, the
DNP degree was most popular,
fol-lowed by PhD in Nursing or
Nursing Education, EdD, and PhD
in non-nursing fields (e.g., PhD in
Behavioral Health and Community)
Health, Human Educational Psy
-chology, Public Policy and Health
Administration, Health Admini
-stration, Higher Education, and
Public Health) Of the 98 NEDG
recipients, 43 were attending
in-state schools while 55 were attend-ing out-of-state programs As of April 2017, two-thirds (67.19%,
n=43) had completed the doctoral
degree for which they had received funding
Recipients reported their cur-rent salary range as follows:
$70,000-$89,999 (42.86%),
$50,000-$69,999 (23.81%), $90,000-$109,
999 (12.7%), $110,000-$130,000 (12.7%), and more than $130,000 (4.76%) The vast majority were employed as full-time faculty
(90.32%, n=56), with 9.67% (n=6)
indicating positions as part-time/adjunct faculty While 40%
(n=25) indicated they expected to
work as a faculty member for 11-20
years, more than one-third (n=22)
expected to work as a faculty mem-ber for 10 years or less
Debt load and how NEDG funds were used. Recipients reported having sizable student debt when they received their awards: 22% owed
$20,000-$49,999, 15.87% owed $50,000-74,999, 12.7% owed
$10,000-$19,999, and 11% owed
$75,000-$99,999 Surprisingly, 9%
report-ed debt of greater than $100,000 with another 5% owing more than
$175,000
NEDG funds were used in the following ways: tuition support for doctoral education (55.56%), repay-ment of student loans from previous educational programs (42.86%), conference attendance/presentation (39.68%), technology support hard-ware/software (38.10%), materials and supplies (34.92%), continuing education to maintain practice
requirements (15.87%), salary for research assistant (9.52%), and course release time (1.59%)
Impact of NEDG on faculty role When asked how important
the NEDG award was in complet-ing a doctoral degree, 85.17% rated it as “extremely important.” One recipient commented, “The NEDG award assisted me in pay-ing off my student loans for my PhD As a result, I did not have to change jobs to obtain an increase
in my salary to pay off my student loans.” Another stated, “Without this award, I would have been forced to do additional hours out-side my teaching role to supple-ment my income The interest on
my loans was accumulating and
my salary alone was not sufficient
to support me and my family The extra time working a second job was slowing down my progress toward completing my doctoral degree.” A third remarked,
“Course release time was by far the most helpful component of this award It allowed me the time necessary to accomplish the course and project requirements
in a timely manner Attainment of
my terminal degree and still ful-filling my responsibilities as a full-time faculty was possible with the help of this award.” The NEDG also provided funding for dissem-ination of scholarly work through conference presentations, both podium (63%) and posters (54.35%)
Recommended strategies to recruit and retain nursing faculty.
Out of 12 possible strategies consid-ered most effective to recruit and retain nursing faculty, the NEDG recipients ranked student loan
for-giveness first (73.44%, n=47),
fol-lowed by scholarships for tuition
(65.63%, n=42), salary supplements (50%, n=32), professional develop-ment (46.88%, n=30), develop-mentorship in the faculty role (40.63%, n=26), and leadership support (34.38%, n=22).
Discussion
The NEDG program has met its goals of increasing the number of
Table 2.
Degrees Sought by Year of NEDG Award
DNP PhD in Nursing EdD PhD Other Total
Trang 5doctorally prepared faculty in
Maryland and retaining them in
teaching positions It is highly
regarded by awardees and clearly
influential in facilitating degree
completion However, several
trends have emerged that require
further exploration Among NEDG
recipients, the DNP degree is the
most popular and is on the rise,
eclipsing the PhD in nursing
Interest in the EdD and non-nursing
PhDs is also high This is consistent
with national trends but is
concern-ing in light of reports doctorally
prepared faculty are preferred over
DNP-prepared faculty (Dreifuerst et
al., 2016) Conversations about the
appropriate educational
prepara-tion for a faculty posiprepara-tion are
need-ed to help degree seekers make the
best choices based on their career
goals and to consider the
implica-tions of having diversity in degree
types among faculty
A large number of NEDG
awardees were attending
out-of-state programs rather than staying
in Maryland At present, there are
two PhD in nursing programs, four
DNP programs, and three EdD
pro-grams Given the availability of
additional funding for tuition and
fees for attending an in-state
school, through the Hal and Jo
Cohen Graduate Nurse Faculty
Scholarship (Maryland Higher
Education Commission, 2018), it
would be important to explore
why Maryland nursing faculty are
choosing out-of-state doctoral
pro-grams with considerably higher
tuition rates
The majority of NEDG
recipi-ents were already burdened by
stu-dent loans at the time of their
NEDG award Some of this debt
extended as far back as their first
undergraduate degree Many NEDG
recipients were not aware they
could include student loan debt in
the budget submission for the
NEDG award, so they often
priori-tized financing new activities over
paying off current student debt
Improvements in the application
directions and revision of the
budg-et template would help address this
issue However, a larger conversa-tion is needed to explore the impli-cations of student loan default, on garnishment of Social Security, and revocation of professional and dri-ver’s licenses (Silver-Greenberg, Cowley, & Kitroeff, 2017)
Faculty salaries emerged as an area of concern for NEDG recipi-ents Given the years of nursing experience among the group, salary levels are modest and not competi-tive with those in clinical practice
With the combination of lower salaries for faculty positions and the costs associated with doctoral degree completion, a career in aca-demia may not be attractive Salary supplementation was
recommend-ed by half of the recipients as a measure to recruit and retain nurs-ing faculty who have invested time and money to advance their education Additional strategies to im -prove faculty compensation need to
be explored as salary issues consis-tently emerge as barriers to the recruitment and retention of high-quality educators (Dreifuerst et al., 2016; Fang, Bednash, & Arietti, 2016; Oermann et al., 2016)
Consistent with national sta-tistics, one-third of NEDG recipi-ents were from the Baby Boomer generation and indicated they would be retiring in the next 10 years While it was encouraging to see that more than 60% were from Generation X, only 40% of them indicated they would be working
as faculty for the next 11-20 years
Exploration of the intentions of this group would be helpful to uncover what might entice them
to stay in their teaching roles In addition, it would be helpful to explore the characteristics of the Millennials who were seeking doctoral degrees at an earlier stage
in their teaching careers and what persuaded them to do so
The NEDG program supported nursing faculty from a variety of racial/ethnic backgrounds;
howev-er, there is room for improvement
More nurse educators from under-represented groups are needed to serve an increasingly diverse
stu-dent population It is critical to encourage academic careers and develop a pipeline of minority edu-cators Mentorship and leadership development are important compo-nents for successful completion of graduate studies and preparation for a faculty role Publicity about the NEDG program featuring awardees from under-represented groups may help in this effort
Despite efforts to encourage nominations from all nursing pro-grams, seven programs did not have any NEDG applicants Further inves-tigation is warranted to uncover the reasons Once this information is known, interventions can be devel-oped to assure wider representation from all 28 programs in the state
While much has been uncov-ered about 65% of the NEDG recip-ients who responded to the survey, little is known about the other 35%
It is equally important to learn about the characteristics and experiences
of the nonresponders Future re -search using other methodologies could provide valuable information
to inform the NEDG program
Conclusion
The NEDG program provided financial incentives to retain and develop a cadre of nursing faculty with terminal degrees The personal sacrifices related to employer expec-tations for higher degree comple-tions are not being matched by
high-er salaries and compensation The student debt crisis is a burgeoning threat to meeting the IOM (2010) goal of doubling the number of
nurs-es with doctoral degrenurs-es Given the risks of losing professional licen-sure, this phenomenon requires fur-ther investigation Furfur-thermore, it is crucial that Maryland’s in-state schools maximize ways to compete for nursing faculty doctoral students, whose tuition and fees could be fully funded through the NEDG and other NSP II programs
Although there is wide agree-ment on the existence of the nurs-ing faculty shortage, there are lim-ited evaluative data to determine the best strategies for addressing
Trang 6it Recruitment and retention
efforts that focus on monetary
incentives to complete doctoral
degrees have been effective with
the NEDG program as described
here However, the NEDG was
developed for full-time faculty
and does not address recruitment
and retention of the growing
num-ber of adjunct, part-time, and
non-benefited nurse faculty positions
Limitations and Future
Investigation
The use of surveys to gather
program evaluation data has
limita-tions including forced choice
responses and completion rates
There are key issues that deserve
deeper investigation Future focus
groups with NEDG recipients could
improve understanding of the lived
experiences of those completing
higher degrees Through increased
awareness of facilitators and
barri-ers to accessing funds or gaps in
funding support, nurse leaders can
advocate for and implement
changes in existing support for
service programs With the burden
of student loan debt and financial
worries noted by the majority of
nurse faculty achieving terminal
degrees, equity in salary or
increased financial support for
edu-cational advancement is urgently
needed Going forward, it is
impor-tant to explore answers to these
nursing workforce issues
Encouraging trends are
evi-dent with the age of nursing
doc-toral students decreasing (NLN,
2017) and the age distribution of
full-time faculty increasing in the
youngest age groups (Fang &
Kesten, 2017) However, intensive
efforts including funding for
workload reduction, tuition
reim-bursement, and mentorship of
tal-ented young faculty must
contin-ue to prepare the next generation
of nurse educators As Dreifuerst
and colleagues (2016) identified in
a study of 548 nurses, issues with
money, time, and program
selec-tion are among faculty concerns
Future research is needed to
expand on these themes In addi-tion, doubling the doctoral com-pletions is insufficient to prepare future faculty for teaching, when neither the PhD in nursing nor the DNP curricula include pedagogi-cally focused coursework to fulfill the role and expectations of a doc-torally prepared nurse faculty
Looking beyond the financial sup-port provided by the NEDG, increasing the completions of doc-toral degrees among Maryland nurse faculty may require a more focused effort such as hosting a statewide forum on doctoral options, expanding support for service programs, and seeking the right program fit for individual
faculty $
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